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An observational study of the utility of continuous positive airway pressure ventilation for appropriate candidates in prehospital care in the Midwest region

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

Emergency medical services (EMS) practitioners in Ireland have been recently licensed to use continuous positive airway pressure (CPAP) ventilation for patients with pulmonary oedema. Both the British Thoracic Society and the Canadian Medical Association advocate the use of CPAP in hospital for patients with severe exacerbations of pulmonary oedema.

Aims

The aim of this study was to identify prehospital patients in the Midwest, over a 6-month period, which could potentially benefit from CPAP if it were available in the National Ambulance Service.

Methods

Potential CPAP patients were identified in the Advanced Paramedic Clinical Activity Study (APCAS) database and then followed up in the receiving hospital emergency department (ED) and medical records. Prior to this study, Irish guidance for prehospital use of CPAP did not exist and therefore the database was interrogated using a Toronto EMS Medical Directive. Descriptive analysis was conducted in Microsoft Excel and SPSS.

Results

Emergency AS1 calls (999/112) were assessed (n = 1369) and 141 patients (10.3, 95 % confidence interval 8.9–12.1 %) were identified as potential candidates for prehospital CPAP. Further investigation of ED records for 63 potential candidates found 36.5 % (95 % confidence interval 26–49 %) met the Toronto EMS criteria for CPAP.

Conclusions

This study suggests that a suitable patient cohort for CPAP exists in the prehospital environment and highlights the need for a prospective study of CPAP use on these patients.

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Author information

Authors and Affiliations

  1. Department of Anaesthesia, Galway University Hospital, Galway, Ireland

    C. Mac Donncha

  2. Centre for Prehospital Research, Graduate Entry Medical School, Health Research Institute, University of Limerick, Limerick, Ireland

    N. Cummins & D. Ryan

  3. National Ambulance Service, Health Service Executive, Limerick, Ireland

    D. Hennelly

  4. Graduate Entry Medical School, University of Limerick, Limerick, Ireland

    A. Hannigan

  5. Retrieval, Emergency and Disaster Medicine Research and Development (REDSPOT), Emergency Department, University Hospital Limerick, Limerick, Ireland

    D. Ryan

Authors
  1. C. Mac Donncha
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  2. N. Cummins
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  3. D. Hennelly
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  4. A. Hannigan
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  5. D. Ryan
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Corresponding author

Correspondence to C. Mac Donncha.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the APCAS study, and ethical approval was obtained for APCAS and was subsequently updated to include the accessing of in-hospital records for CPAP data which was approved by the APCAS Ethics Committee.

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Mac Donncha, C., Cummins, N., Hennelly, D. et al. An observational study of the utility of continuous positive airway pressure ventilation for appropriate candidates in prehospital care in the Midwest region. Ir J Med Sci 186, 489–494 (2017). https://doi.org/10.1007/s11845-016-1456-0

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  • DOI: https://doi.org/10.1007/s11845-016-1456-0

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